COMMUNITY HEALTH NURSINGPHYSICAL EXAMINATION NEW BORN BABY
QUESTION ?EXPLAIN THE PHYSICAL EXAMINATION FOR NEW BORN
PURPOSE1. To identify characteristics of the normal newborn.2. To identify congenital abnormalities of birth injuries.3. To facilitate early treatment of baby to avoid complication4. To obtain baseline data for continuous assessment.
ASSESSMENT1. Observe general condition of baby : -skin colour-centrally pink, present lanugo and vernix -Baby active or not (hand and leg movements) -Strong cry or not
ASSESSMENT3.Check baby’s head: Moulding , caput succedaneum ,cephalohematoma Size of fontanalle: - Anterior(can admit 2 finger,closes at 18month) -Posterior(can admit 1 finger and close at 2- 3 month)Birth injuries(bruises,wound on scalp)
ASSESSMENT4.Examine:• Face for characteristics of Down’s syndrome like:• Upward slanting of eyes with thick epicqnthic folds• Small mouth with thick tounge and always sticking out• Nose-flattened• Low set ears
ASSESSMENT5.Eyes:• Has 2 eyeballs• Lens clear and without cataract• Can open eyes spontaneously• No bleeding in the sclera
ASSESSMENT6.Mouth• No cleft lip• Feel inside baby’s mouth to identify for signs of cleft palate• Presence tongue tie• Check for presence teeth
ASSESSMENT7.Nose• Has 2 nostrils• Any nasal flaring
ASSESSMENT8.Ears• Check position of ears : upper notch pinna same level of the canthus of the eye.• Check if auditory meatus(canal) is patent.• Has ear lobes
ASSESSMENT9.Check neck-by lifting chin up to observe for:• Enlargement of thyroid gland• Sternomastoid tumour (palpate side of neck)
ASSESSMENT10.Check hands• Both hand same length• Both hand can move• Palm of hand has 3 normal creases and not the “simian crease”• Any fracture,dislocation and paralysis• Check for grasp reflex
ASSESSMENT11.Check chest for:• Chest movement during respiration to identify for sterna/ intercostals recession.• Pigeon chest(chest appears to be higher)• Nipple well formed and no extra nipple
ASSESSMENT12.Check abdomen :• Shape-convex• Soft• Umbilical cord(has 2 arteries and 1 vein)• No bleeding should be clamped properly• No umbilical hernia• Exomphalus/gastrochiasis
ASSESSMENT 13.Check genitalia : • Identify sex and ensure if it is not ambigous Male femaleBoth testis descended Has labia majora and minora and vaginal orifeNo epispadias,hypospadias A little of whitish mucus is normalNo hydrocele,no phimosis Presence of smegma in labiaminora is normal
ASSESSMENT13.Check feet:• Both leg are of same length• No fracture and paralysis• No talipes• Both legs have sufficient toes and no decrease number of digits on the toes.
ASSESSMENT14.Check baby’s back :• Turn baby to the side and ensure baby’s back is straight and flat.• Use the fingers and check from neck to sacrum• Ensure there is no dimples curves,lumps ‘hair tuft’ and spinal bifida.
ASSESSMENT15.Anus :• Check to ensure anus patent• Insert rectal temperature into the anus as far as 2.5cm• Place baby in lateral position for this procedure